Youth Behavioral Health at Risk: Local Report Points to Need for “Upstream” Strategies

SAN ANTONIO (April 3, 2019) – It is widely known and accepted that early intervention and prevention are key to improved care for cardiovascular health, diabetes, and cancer, but when it comes to behavioral health the early prevention practice is lacking. There is currently an average of eight years between the initial onset of mental health symptoms and access to treatment. Behavioral health encompasses both mental health and substance abuse, which are often interrelated.

Bexar County stakeholders have been interested in addressing the system barriers preventing providers from delivering vital services to children and youth in our community with behavioral health needs. A group of dedicated women representing multiple industry sectors who would meet monthly to discuss the community’s needs, often at the home of community leader Barbara Gentry, had surfaced behavioral health as a key issue and need. “Mental health impacts virtually every family, since one in five youth and one in four adults experience some degree or form of mental illness”, says Gentry. 

Because of this community-generated interest in addressing behavioral health, the Kronkosky Charitable Foundation and the San Antonio Area Foundation funded the Bexar County Children and Youth Behavioral Health Assessment to research current capabilities and capacities while underscoring national evidence-based practices. This report ultimately highlights the need for earlier behavioral health support for Bexar county youth based on research and surveys of key organizations currently serving this demographic. 

A key finding in the report is that half of all mental health conditions manifest by age 14 and interventions work best at an early stage when symptoms are less severe, more treatable, and readily prevented from escalating to more dangerous conditions that increase risk. Estimates reveal that there are approximately 130,000 children and youth in Bexar County ages six to 17 that have behavioral health needs.

This report describes an “Ideal System of Care” for children, youth, and families to prevent and increasingly detect and treat behavioral health needs sooner.  It also identifies the strengths and challenges regarding the current delivery system within each component of the ideal system.  

The report, written by researchers at The Meadows Mental Health Policy Institute for Texas, had two project goals:

  • Identify “upstream” (i.e., before symptoms emerge or closely thereafter) strategies to continue development of the community’s behavioral health systems impacting children and youth; and
  • Provide recommendations for opportunities expected to come out of the 86th Legislature to improve upstream interventions.

Moving the delivery of behavioral health supports upstream, and emphasizing a range of prevention strategies to prevent or at least minimize symptom emergence is essential to both the treatment of mental illness and substance use disorders, as well as the promotion of mental wellness.  

“Right now, our children’s mental health system is set up so that we intervene when there is a crisis,” said Becca Brune, president and COO of the San Antonio Area Foundation.  “Common sense holds that prevention as a lead strategy is better than cure, as there are strong socio-economic reasons for investing in prevention and early intervention,” said Brune.

Another key component of this report is its timing. Children’s mental health will be a prominent focus during the 86th Legislative Session, creating a number of legislative opportunities for San Antonio. 

 “This report advocates for increased funding to improve prevention and school-based supports so that a child’s first behavioral care service is not through the juvenile justice system or in an emergency room,” said Tullos Wells, managing director of the Kronkosky Charitable Foundation.

The next steps for this project are to convene health and other child-serving systems to discuss the findings and recommendations of this report and consider multi-level, coordinated approaches for behavioral health service delivery, advocacy and philanthropy.  “Community leaders are ready to assess the report’s results in order to identify, prioritize and implement solutions”, says Melody Woosley, Human Services Director for the City of San Antonio. Woosley and leaders from over 20 organizations participated in the study and are collaboratively determining solutions.

Download Report


About the San Antonio Area Foundation: The San Antonio Area Foundation has served as the sole, designated community foundation for the San Antonio area for over half a century, growing to become one of the top 20 foundations in the nation based on asset size. The Area Foundation helps donors achieve their charitable goals, managing more than 500 charitable funds approaching $1 billion in assets. Coordinating efforts with numerous area nonprofits, the Area Foundation serves as a collaborative leader, connecting donors to address key community issues and investing in our future. Since 1964, over $400 million in scholarships and grants have been awarded to enhance the quality of life in our region. Learn more about our community foundation at

About the Kronkosky Charitable Foundation: The mission of the Kronkosky Charitable Foundation is to produce profound good that is tangible and measurable in Bandera, Bexar, Comal and Kendall by implementing the Kronkoskys’ charitable purposes. The foundation, established by Albert and Bessie Mae Kronkosky in 1991, received an endowment of $295 million from the estate of Albert Kronkosky Jr. in 1997 and has become the single, largest source of charitable giving in the four-county region.   Since 1998, the Foundation has distributed $284.9 million in grants, awarding more than $15 million annually.  The foundation supports health and human services, cultural activities, parks, zoos and wildlife sanctuaries, animal cruelty prevention and assists victims of public disasters in Texas. 

303 Pearl Parkway, Suite 114
San Antonio, TX 78215

The San Antonio Area Foundation helps donors achieve their charitable goals for the greater benefit of the community.

Contact Information

(210) 225-2243   Email Us

Working With Us

Access My Fund   Board Login

Connect with us